Right-sided laparaoscopic donor nephrectomy is feasible: Experience with three cases

Abstract 

Background

Laparoscopic donor nephrectomy (LDN) is more difficult on the right than the left and is typically not recommended for the right kidney.

Materials and methods

Between November 2002 and May 2003, three patients underwent right-sided donor nephrectomy: one transperitoneally and two retroperitoneoscopically. All procedures were performed in the right kidney position. Three ports were placed for retroperitoneoscopic approach and four for transperitoneal, including one to retract the liver. Renal arteries were clipped thrice and divided, and renal veins divided using an endo-GIA30 stapler. Kidneys were retrieved in all cases by extending the lower port incision by 7 to 8 cm. The records of donors and recipients, including early graft outcomes were reviewed.

Results

Kidney retrieval time and total warm ischemic time were 3:30 minutes and 5 minutes, respectively, for transperitoneal LDN and 3:40 to 4:10 minutes and 5 to 7 minutes, respectively, for retroperitoneal LDN. The operating times were 176, 224, and 160 minutes, respectively. The first donor (transperitoneal) was discharged on the fourth postoperative day, and the other two (retroperitoneal) on the third day. The serum creatinine of all recipients normalized within 72 hours, with normal isotope renal scans on the fifth postoperative day.

Conclusions

Right-sided LDN is feasible and safe without adversely affecting graft quality. The retroperitoneal approach is technically easier, gives a longer length of renal artery, and has a quicker convalescence.